Q3 Urgent Caring- New: Urgent Updates in Pediatrics


Urgent Care Physician and Medical Lead Kings College Hospital Urgent Treatment Centre, London
Abstracts Section Editor, Journal of Urgent Care Medicine  
Convenor Ireland and UK Faculty of the Royal New Zealand College of Urgent Care
Independent Assessor European Reference Network, Andalusian Agency for Healthcare Quality

Anxiety and Depression Treatment in Pediatric Population

There has been a rise in anxiety and depression in the pediatric population in the U.S. and globally. Primary and Urgent Care are frequently the first point of contact for patients with these conditions. Engagement in care is crucial as exclusive management by subspecialist isn’t feasible due to the high prevalence of these conditions, a shortage of trained subspecialty clinicians, long wait lists, and insurance challenges. This was a medical record review study to determine whether PCPs followed clinical practice guidelines when providing care to children and adolescents who had been prescribed an SSRI medication for anxiety and/or depression.

The authors randomly selected 110 cases for review and found that in 82% of cases, PCPs documented reasons for starting an SSRI, most commonly clinical change (57%). PCPs documented psychiatry or developmental behavioral pediatrics subspecialist involvement in 30% of cases and referred 34% of patients for nonspecific psychotherapy. PCPs documented the use of a screening tool (e.g., SCARED, GAD-7, PHQ-9) in 26% of patients. Full Access: AAP

Is Immunotherapy the Answer to Peanut Allergy?

Peanut allergy affects approximately 2% of the U.S., Canadian and worldwide population and is a common cause for pediatric anaphylaxis. There are presently no approved therapies for children under 4 years. This was a phase 3, double-blind, randomized, placebo-controlled trial at 51 sites in eight countries across the United States, Canada, Australia, and Europe. The trial was conducted between July 2017, and April 2022, and 362 patients were randomized. An epi-cutaneous peanut patch system was used as a therapeutic device and the placebo group received a similar device without the peanut ingredient.

The authors found treatment with a peanut patch was superior to placebo in desensitizing children 1 to 3 years of age with peanut allergy. Anaphylaxis was reported in 7.8% of patients in the intervention group and 3.4% of those in the placebo group. 3.3% of patients discontinued the study in the intervention group and there were no discontinuations in the placebo group.

Comments – The study’s participants were highly selected to those without severe allergies or anaphylaxis reactions prior, therefore generalization is limited. This study, however, is the first to use a non-oral approach to food desensitization and may have some future application of peanut and other allergy treatments. Full Access: AAP